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HomeMy WebLinkAboutSWG2022-00528 - SWG As-Built - 3/30/2023 Mason County OSS Installation Report pg. 1 C' C' MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2022-00528 Parcel # 22114-14-50040 Applicant Name Crystal Mannila Subdivision (Name/Div/Block/Lot) Applicant Address P.O. Box 1221 LOT 4 OF LLS#07-08 S 38/108 City, State, Zip Allyn, WA 98524 Installer Name Arrow Excavating Site Address 120 E Wid Grape Way, Grapeview Designer Name Arrow Septic Designs INSTALLATION CHECKLIST © Full System Installation ❑ Tank(s)Only ❑ Drainfield Only ❑ Repair ❑Other System Type Shallow Pressure Pretreatment Type >5 ft. from foundation? - - -NO-1A9�S-g-(• t.- , N/A YES NO >50 ft. from wells? - 1 -� �� �- I� ❑■ ❑ >50 ft. from surface water? - El Z -MAK-29Jtb2-3- _l • Cleanout between building and tank? - - - - - ❑■ ❑ V Tank baffles present? - N 0 Ela 24"access risers over each compartment?- - By - - - - r i El W Effluent filter installed?- - ❑ 0 El co Septic tank capacity (working) 1,200 gal Manufacturer Hagerman El D-box water level and speed levelers used? - - ❑l N/A ❑ YES ❑ NO oO Manifold/D-box accessible from surface?- - ❑ ❑ El Da Check valves installed? - - El ❑■ El 2 Transport Line Size 2 inch Schedule/Class 40 Bedrooms installed (check one) ❑ 2 ■❑ 3 0 4 ❑ 5 ❑6 ❑Commercial/Other >10 ft. from foundation?- - ❑ N/A ❑■ YES ❑ NO O >100 ft. from wells?- - ❑ El ❑ W >100 ft. from surface water? - - El 0 ❑ LT >10 ft. from potable water lines?- - ❑ ❑■ ❑ a Z > 5 ft. from property lines and easements?- - El 0 ❑ at > 30 ft. from downgradient curtain/foundation drains? - - © El El Drainfield level and observation ports present - - ❑ © El ❑ Graveless chambers or ® Clean gravel used? (check one) Proper cover installed over drainfield?- - ❑ 0 El Pump tank setbacks consistent with septic tank?- - ❑ N/A ❑■ YES ❑ NO Y Pump tank capacity (flood) 1,000 gal Manufacturer Hagerman Z N24" access riser(s) and accessible from surface?- — - CI I El a Alarm or Control Panel Installed? - krT }WALL - El El IN • Control Panel equipped with Timer/ETM /Counter- - El © ❑ a Pump installed in ❑ Bucket or 0 On Block or El Other a PumpMake/Model Liberty290� ❑ Floats or IMI Transducer a Tank draw down 3 in/min Pump capacity 57 gpm Squirt Height 9 ft Pump on time 1.5 Minutes Pump off time 6 Hours Daily flow set at 342 gpd ' .:otlateo 8/21:7C18 Mason County OSS Installation Report pg. 2 Parcel# 2211 T — \ -SO 040 ABANDONMENT RECORD Were existing septic components abandoned as part of this project? - ❑ YES 17( NO If yes, please describe: ❑ NO Were all components pumped out and properly abandoned per WAC246-272A-0300? - - ❑ YES RECORD DRAWING This is a permanent record and must be accurate and descriptive enough to re-locate in the need of maintenance activities and future development Typical Record Drawings contain: Dralnfield&manifold orientation&layout.Septic/pump tank location,North arrow,reserve drainfield,existing and proposed be!dings,location of wells.waterlines, wells,observation ports,deanouts,and other maintenance access points. Incomplete Record Drawings may create additional delays in final installation approval and related permits. Record Drawing Attached CERTIFICATION OF INSTALLATION INSTALLER DESIGNER/ENGINEER I certify that I installed the system in accordance with I certify that the system has been installed in accor- the septic design stamped"APPROVED"by Mason dance with the septic design stamped"APPROVED'by County Public Health and that any deviations shown Mason County Public Health and that any deviations here have been cleared/approved by both the designer shown here have been cleared/approved by both and Mason County Public Health and meet all State myself and Mason County Public Health and meet all and Mason County Codes. State and Mason County Codes I further certify that all infor ation contained on this I further certify that all information contained on this form attached R ord Drawl 4,1ccurate. form and attached Record Drawing is accurate. • OZ--2-S nature of Installer Date p } )D1v\ C--)*t <<, 6--v\01 Printed Name of Signee o1 y h wA• a .� i MASON COUNTY PUBLIC HEALTH 13 . 1 u •�� The undersigned approves this Installation Report and . 5, , Record Drawing on behalf of Mason County Public p. FIAULA JOY JOHNSON.: ). s �l�9i' 'r.`'`r�,ci3s Health: Signature of Enviro Health Specialist Date si nature and date) (stamp, 9 THIS FORM MAY BE SCANNED AND AVAILABLE FOR PUBLIC VIEW ON THE MASON COUNTY WEB SITE Uptatec 82'./23 8 • . Rem OAudio-Visual Alarm c3 Cleanout It 4)41 413"1 3 1200 Gallon Septic Tank V, t✓ `J 2-Compartment with (..am,tk-_,.. ...,,Q- Effluent Filter r�_ i :{DO c a` `• )® 4 1000 Gallon Pump Chamber 0 30 �e aD tSC O I OS Valve Control Box AS-3\A i LT • n • `x --t z)340 4(2)5'X"' e„ n. • 2Zi d. LA-_C04b ^,-i -t QYV D. e- frAiii....,,., . ,,,....,. 41! % /7. : Std9c • O �./' ` - s Nelg4,bor \00 _ _ We\ er — -- \ / . \ko s"' O VE N. /\ ,, o SON C0U Mq R 3 2023 . - N, • \ \ 1 Nh"EN�RONMENTAC HEALTH �'� ........-e ... :=Nh. RET A\ .p` \ 01 Oa 0 WEitand CiSevne bk 44'. .4t r \ ' `j yy 57 Cu3�9 !� �pS 4 PAULA OY JOHNS0�1 •'' ,1 \ et,, '', ,c11-.I.giV4:: 3 :(_Z- ,